Percentage of patients who undergo a procedure under anesthesia in which a permanent intraoperative anesthesia staff change occurred, who have a documented use of a checklist or protocol for the transfer of care from the responsible anesthesia practitioner to the next responsible anesthesia practitioner.
Lack of communication or miscommunication between anesthesia providers during staff change can lead to patient harm.1,2 Organizing these staff changes using a predefined handoff checklist ensures this communication occurs, and is as accurate and efficient as possible.3-5
Anesthesia Start to Anesthesia End
For cesarean delivery conversion cases: 5 minutes after Cesarean Delivery Start Time to Anesthesia End.
Documentation of intraoperative transfer of care report in the electronic anesthesia record.
Only permanent intraoperative handoffs between in-room providers will be considered for this measure. If an attending and CRNA/AA or resident is signed into a case, only the in-room provider (CRNA/AA or resident) permanent handoff events will be tracked. If only an attending is signed into the case, the attending will be responsible and measured on the handoff performed.
If more than one permanent intraoperative handoff occurs during the case, all events will be considered for determining success. If an intraoperative handoff is not documented for any handoff event, the case will be flagged. The percentage of handoffs will be calculated as number of handoffs documented as completed in the electronic anesthesia record where the denominator equals the number of permanent intraoperative handoff events. Only those providers involved in the event without a documented handoff will be attributed.
A permanent handoff is defined as:
A staff change is defined as the in-room provider documenting sign-out and another signing in within 5 minutes before or after the sign out.
The accepted time frame for documenting the intraoperative handoff is 15 minutes before to 15 minutes after the staff change.
The key handoff elements that must be included in the transfer of care protocol or checklist include:
* For labor epidurals which convert to cesarean deliveries where the procedures are combined under one case ID, 'Cesarean Delivery Start Time' is used as the 'Measure Start Time'
Both providers involved in the transfer of care communication (provider signing in and the provider signing out).
|Date Reviewed||Reviewer||Institution||Summary||QC Vote|
Alex Bouwhuis, MD
Eric Davies, MD
Henry Ford - Allegiance